Healthcare Provider Details

I. General information

NPI: 1821130303
Provider Name (Legal Business Name): JERRY LYNN MCCRACKEN M.S.,L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN MCCRACKEN

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 GLENWICK DR
PLANO TX
75075-4201
US

IV. Provider business mailing address

1616 GLENWICK DR
PLANO TX
75075-4201
US

V. Phone/Fax

Practice location:
  • Phone: 972-971-0632
  • Fax:
Mailing address:
  • Phone: 972-971-0632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number62618
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: